Finally managed to acquire an example of one of these. It is described as being the highest international award to Nurses being instigated in 1912 although the first awards were in 1920 due to the First World War. It is awarded every two years on May 12th,the birthday of Florence Nightingale and to date a total of 1,483 have been issued.The award criteria is"Exceptional courage and devotion to the wounded, sick or disabled or to civilian victims of a conflict or disaster" or "exemplary services or a creative and pioneering spirit in the areas of public health or nursing education.

This particular medal is unnamed and may have had the name erased.It is hallmarked for 1922 so may have been one of those at the second award ceremony?